Nishi Okihiro, Nishi Yutaro, Tatsumichi Miki, Yasukawa Tsutomu
Jinshikai Medical Foundation, Nishi Eye Hospital, 4-14-26 Nakamichi, Higashinari-ku, Osaka 537-0025, Japan.
Department of Ophthalmology and Visual Science, Nagoya City University Graduate School of Medical Sciences, Nagoya 464-8601, Japan.
J Clin Med. 2024 Aug 14;13(16):4777. doi: 10.3390/jcm13164777.
To attain an understanding of pachyvein formation seen with central serous chorioretinopathy (CSC) by measuring the choroidal blood flow (CBF) velocity and to apply the findings to existing hydrodynamic theorems. Nineteen subjects with monocular CSC (mean age 51.8 ± 12.7 years) were included. Laser speckle flowgraphy measured the mean blur rate (MBR) in the foveal and perifoveal regions, and the findings were applied to the Equation of Continuity (Q = AV) and Bernoulli's theorem (1/2V + P/ρ = constant). The mean foveal/perifoveal MBRs in the CSC eyes were 6.4 ± 3.2/9.6 ± 3.2 ( < 0.001). The mean MBRs in the non-CSC eyes were 8.3 ± 3.2/7.9 ± 2.4 ( = 0.37). The significant foveal CBF velocity decrease in CSC eyes occurs because of exudation from the hyperpermeable choriocapillaris. The subsequent decrease in blood volume due to the exudation elicits a decrease in the blood flow velocity in the inferior venules in accordance with the Equation of Continuity. The decrease in the blood flow velocity may result in an elevated blood flow pressure in the inferior venules and veins at the exudation site, in accordance with Bernoulli's theorem. A significant decrease in the foveal MBR may result from exudation from the hyperpermeable macular choriocapillaris. This decreased velocity may elicit a blood pressure elevation that can expand the inferior venules and veins at the exudation site, so-called pachyvein and pachychoroid formation. The application of hydrodynamic theorems to the measurement of ocular blood flow can provide new insights into the understanding of the pathogenesis of chorioretinal disease.
通过测量脉络膜血流（CBF）速度来了解中心性浆液性脉络膜视网膜病变（CSC）中厚静脉的形成，并将研究结果应用于现有的流体动力学定理。纳入19名单眼CSC患者（平均年龄51.8±12.7岁）。激光散斑血流图测量了黄斑中心凹和中心凹周围区域的平均模糊率（MBR），并将结果应用于连续性方程（Q = AV）和伯努利定理（1/2V + P/ρ = 常数）。CSC患眼的平均中心凹/中心凹周围MBR为6.4±3.2/9.6±3.2（<0.001）。非CSC患眼的平均MBR为8.3±3.2/7.9±2.4（=0.37）。CSC患眼中显著的中心凹CBF速度降低是由于高渗透性脉络膜毛细血管的渗出所致。渗出导致的血容量减少会根据连续性方程引起下小静脉血流速度降低。根据伯努利定理，血流速度降低可能导致渗出部位下小静脉和静脉的血流压力升高。中心凹MBR的显著降低可能是由于高渗透性黄斑脉络膜毛细血管的渗出所致。这种速度降低可能会引起血压升高，从而使渗出部位的下小静脉和静脉扩张，即所谓的厚静脉和厚脉络膜形成。将流体动力学定理应用于眼部血流测量可为理解脉络膜视网膜疾病的发病机制提供新的见解。
